Family Medicine Reaches New High in 2018 NRMP Match

Target Set for 25 Percent by 2030

The results are in for the 2018 National Resident Matching Program (NRMP) Main Residency Match, and this year's numbers highlight some significant accomplishments for family medicine.

The Schwab family is all smiles today at the University of Utah School of Medicine in Salt Lake City after learning that dad, Tyson, matched to the Utah Valley Family Medicine Residency in Provo; Schwab's wife, Danielle, daughter Ila and son Koen join in the celebration.

For instance, NRMP information made public today reveals

3,654 positions were offered in family medicine this year -- 276 more than in 2017,

3,535 medical students and graduates matched to family medicine -- 298 more than in 2017, and

a 96.7 percent fill rate for family medicine residency programs -- the highest ever recorded for the specialty and nearly a percentage point higher than in 2017 (95.8 percent).

The number of U.S. seniors matching to family medicine also increased in 2018. A total of 1,648 U.S. seniors -- defined by the NRMP as those graduating from an M.D.-granting medical school -- matched to family medicine residency programs this year, compared to 1,530 in 2017.

This annual event, often referred to simply as the Match, marks the culmination of a student's medical school education and propels new graduates into additional specialized training in U.S. residency programs.

Story Highlights

The 2018 National Resident Matching Program numbers are in, and family medicine showed the highest number of matches ever.

2018 was the ninth consecutive year of increases in the number of matches to family medicine residency programs.

The nation's eight leading family medicine organizations have set a target for 2030 that would have 25 percent of U.S. graduating M.D. and D.O. students matching to a family medicine program.

AAFP President Michael Munger, M.D., of Overland Park, Kan., noted the significance of the 2018 Match numbers. "This was the best Match showing ever recorded for family medicine and represents nine straight years of increases for the specialty," Munger said in an interview with AAFP News.

He also congratulated the new family medicine recruits with this message: "You've matched into a specialty that demands rigorous training to support full-spectrum comprehensive health care.

"The patients and communities you serve during your residency training will be well cared for and will reap the benefits of compassionate and coordinated primary care," said Munger.

More Match Highlights

More positive news come out of the 2018 Match numbers, as well. Consider that family medicine residency programs

offered 12 percent of all positions available, compared to 11.7 percent in 2017;

reported a 46.6 percent fill rate for U.S. seniors, compared to 45.3 percent in 2017; and

matched 9.3 percent of all U.S. seniors, compared to 8.8 percent in 2017.

This was family medicine's largest Match ever, and one has to reach all the way back to 1997 to find the historical high of 2,340 U.S. seniors matching to the specialty.

Readers doing their own comparisons should note that AAFP Match calculations include students matching into traditional family medicine residency programs, as well as programs that combine family medicine education with other focused training.

Those additional programs are family medicine/emergency medicine, family medicine/preventive medicine, family medicine/medicine, family medicine/psychiatry, and family medicine/osteopathic neuro-musculoskeletal medicine.

Phasing in a Single Accreditation System

There's a big shift taking place in graduate medical education as the American Association of Colleges of Osteopathic Medicine and the Accreditation Council for Graduate Medical Education (ACGME) transition to a single accreditation system.

That process will be complete at the close of 2020, at which time most D.O. and M.D. applicants will participate in a unified NRMP Match.

The AAFP's Senior Vice President for Education Clif Knight M.D., told AAFP News that until that transition is achieved, it will be difficult to get an accurate snapshot of family medicine's expansion.

For example, overall numbers in the American Osteopathic Association (AOA) Match were down in 2018 because some of those programs have already made the transition, but the NRMP picked up spots.

"Although there were fewer family medicine positions filled in the recent AOA Match, the NRMP Match increase makes up for those losses. We're left with a true net growth of 191 matches to family medicine, a higher number than in past years and a significant step forward in this year's Match," said Knight.

Additionally, the NRMP's method of data reporting counts only allopathic medical students in the total number of U.S. matching seniors but includes osteopathic medical students along with all other graduates in different calculations. That keeps the number that reflects U.S. graduates artificially low.

In coming weeks, the AAFP will undertake its annual residency census and medical school study where staff experts drill down into Match statistics, some of which are not yet available. That report, scheduled for release in the fall, "will give us a more complete picture of the growth in family medicine and where that growth is coming from," said Knight.

Knight also gave a shout out to residency programs. "I served as a program director, and I know what an accomplishment it is to see the vast majority of programs filled. Today, I congratulate program directors for their outstanding work."

New Target for Family Medicine

Despite the well-deserved kudos and celebrations related to the upbeat trends, Munger cautioned there is still work ahead.

"AAFP research(www.stfm.org) shows us that the U.S. health care system is out of balance; we have too many subspecialists and not enough primary care physicians. Our GME system is not meeting the nation's physician workforce needs," said Munger.

Victoria Boggiano proudly displays her Match notification letter during today's celebrations at the Stanford University School of Medicine in California; Boggiano is headed to the University of North Carolina Family Medicine Residency in Chapel Hill for the next phase of her medical training.

"Family medicine is the only specialty totally devoted to primary care, and as such, provides the solid foundation our system needs and that the people of this country deserve."

In short, expanding family medicine will improve health care nationwide.

To that end, a new target was recently set by the eight leading family medicine organizations in the United States, who understand the need to increase the number of U.S. medical students who choose to become family physicians.

Specifically, by 2030, the organizations want to see 25 percent of those graduating M.D. and D.O. medical students matching to a family medicine program.

That goal was agreed upon by the AAFP, the AAFP Foundation, the American Board of Family Medicine, the American College of Osteopathic Family Physicians, the Association of Departments of Family Medicine, the Association of Family Medicine Residency Directors, the North American Primary Care Research Group and the Society of Teachers of Family Medicine.

It's an ambitious target, said Munger, given that the combined allopathic and osteopathic overall Match results currently yield a family medicine fill rate of about 12 percent.

"Doubling the number of family medicine recruits in the next 12 years will take a multifaceted effort that includes increasing the number of residency positions," said Munger.

In addition, the Academy will continue, through its advocacy efforts, to

highlight the value of primary care and family medicine,

fight for appropriate pay for family physicians,

improve family physicians' work environment, and

strengthen the primary care pipeline by ensuring that students who are interested in pursuing primary care can get into medical school.

Lastly, once in medical school, those students need strong family physician role models to pique their curiosity and steer them to family medicine.

Munger urged his family physician colleagues to fill that role by mentoring and precepting medical students. "Give them a real taste of the joy of family medicine by inviting them into your practice to see the the relationships you develop with your patients and how you impact their lives," said Munger.